University of Health Sciences Turkey Ankara Gulhane Education and Research Hospital, Department of Neurology Ankara, Turkey.
University of Health Sciences Turkey Istanbul Erenkoy Mental Health and Neurological Disease Education and Research Hospital, Department of Neurology Istanbul, Turkey.
Ideggyogy Sz. 2023 Mar 30;76(3-4):129-139. doi: 10.18071/isz.76.0129.
Obstructive sleep apnea syndrome (OSAS) may cause daytime sleepiness, mood changes and dysfunction in various cognitive areas due to recurrent arousals and / or chronic intermittent hypoxia. Different possibilities have been proposed regarding the most affected cognitive areas and mechanisms of OSAS. However, it is difficult to compare findings of the different studies due to the fact that individuals with different disease severities were included in the study groups. In the current study, we aimed to determine the relationship between severity of OSAS and cognitive functions, to investigate the effect of continuous positive airway pressure (CPAP) titration treatment on cognitive functions and the relationship between these changes and electrophysiological potential.
.The study included 4 groups of patients with simple snoring and mild, moderate and severe OSAS. In the pre-treatment evaluations, verbal fluency, visuospatial memory, attention, executive functions, language abilities and electrophysiological tests for event-related potential were performed. The same procedure was reapplied after 4 months of CPAP-therapy.
.Long-term recall scores and total word fluency scores were found to be low in the groups with moderate and severe disease compared to the patients with simple snoring (p: 0.04, p: 0.03, respectively). The information processing time was higher in patients with severe disease compared to patients with simple snoring (p: 0.02). The P200 and N100 latencies related to event related potentials (ERP) were significantly different between the groups (p: 0.004, p: 0.008, respectively). After CPAP treatment, significant differences were found in N100 amplitude and latencies and all cognitive areas except abstraction. In addition, N100 amplitude and latency change rate as well as change in attention and memory abilities were correlated (r: 0.72, p: 0.02; r: 0.57, p: 0.03, respectively).
.In the current research, disease severity was found to negatively affect long-term logical memory, sustained attention and verbal fluency. Moreover, significant improvement was detected in all cognitive areas with CPAP treatment. The findings of our study support that changes in N100 potential have the potential to be used as a biomarker that can be used to monitor cognitive function recovery after treatment.
.阻塞性睡眠呼吸暂停综合征（OSAS）可能会因反复觉醒和/或慢性间歇性缺氧而导致白天嗜睡、情绪变化和认知领域的各种功能障碍。对于 OSAS 最受影响的认知区域和机制，已经提出了不同的可能性。然而，由于研究组中包含了不同疾病严重程度的个体，因此很难比较不同研究的结果。在本研究中，我们旨在确定 OSAS 严重程度与认知功能之间的关系，研究持续气道正压通气（CPAP）滴定治疗对认知功能的影响，以及这些变化与电生理潜能之间的关系。
.本研究包括单纯打鼾和轻度、中度和重度 OSAS 的 4 组患者。在治疗前评估中，进行了言语流畅性、视空间记忆、注意力、执行功能、语言能力和事件相关电位的电生理测试。在 CPAP 治疗 4 个月后，再次进行相同的程序。
.与单纯打鼾的患者相比，中度和重度疾病组的长期回忆评分和总单词流畅性评分较低（p：0.04，p：0.03）。与单纯打鼾的患者相比，严重疾病患者的信息处理时间较高（p：0.02）。与事件相关电位（ERP）相关的 P200 和 N100 潜伏期在组间差异显著（p：0.004，p：0.008）。CPAP 治疗后，N100 振幅和潜伏期以及除抽象外的所有认知领域均有显著差异。此外，N100 振幅和潜伏期的变化率以及注意力和记忆能力的变化与（r：0.72，p：0.02；r：0.57，p：0.03）相关。
.在本研究中，发现疾病严重程度对长期逻辑记忆、持续注意力和言语流畅性产生负面影响。此外，CPAP 治疗后所有认知领域均有显著改善。我们的研究结果支持 N100 潜能的变化有可能作为治疗后监测认知功能恢复的生物标志物。
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